Productivity measures are typically comprised of single variables that do not take into account the multitude of individual metrics that constitute a complex workflow process. In the case of medicine for example, a physician, technologist, administrator or information technology (IT) specialist must go through multiple individual steps to complete a process. For physicians, these multi-step processes can include interpretation of a medical imaging exam (radiologist), performance of medical consultation (internist), admitting history and physical (hospitalist), or complex surgical procedure (surgeon). Regardless of the specific process or job description, the workflow processes performed are far too complex to measure in beginning and end times alone.
For years, a metric termed the relative value unit (RVU) was used as the primary measurement tool to predict the time and effort required within medical imaging to complete the performance and interpretation of a medical imaging exam. This Productivity metric was in turn tied to economic reimbursement, with the general idea that RVU's were directly proportional to the time and effort spent in performing the procedure and as a result should correlate with the economic payment. A number of problems existed with this system, most notably the fact that RVU's were calculated long ago before the development of current technologies (imaging and information system technologies), RVU's were not directly tied to quality measures, and RVU's did not take into account variability (between practitioners) of data being analyzed and workflow differences. As a result, two individuals performing the same function (e.g. interpretation of a chest CT (computed tomography)) were reimbursed in an identical fashion, regardless of significant differences in the technology used, number and type of data being reviewed and analyzed, and overall accuracy of the interpretations.
To illustrate how present productivity and quality may vary, a few Comparative Examples are provided in the Examples section below.